Claim total
$270.86
base $93.39 · payer covered $220.86
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-05-28
- Stop
- 2020-05-28
The parties
- Patient
- patient Ezekiel Demarcus Roob
- Provider
- provider Silas Conn
- Payer
- payer Medicaid
Record id
2e1a22fb-46ba-3fcc-25c3-60f56803ba7c